Pulmonary cytomegalovirus (CMV) DNA shedding in allogeneic hematopoietic stem cell transplant recipients: Implications for the diagnosis of CMV pneumonia.
Adult
Aged
Aged, 80 and over
Bronchoalveolar Lavage Fluid
/ virology
Cytomegalovirus
/ genetics
Cytomegalovirus Infections
/ diagnosis
DNA, Viral
/ genetics
Female
Hematopoietic Stem Cell Transplantation
Humans
Male
Middle Aged
Pneumonia, Viral
/ diagnosis
Retrospective Studies
Transplant Recipients
Transplantation, Homologous
Viral Load
Virus Shedding
CMV DNA in BAL
CMV DNAemia
CMV pneumonia
Cytomegalovirus
Pre-emptive antiviral therapy
Journal
The Journal of infection
ISSN: 1532-2742
Titre abrégé: J Infect
Pays: England
ID NLM: 7908424
Informations de publication
Date de publication:
05 2019
05 2019
Historique:
received:
23
03
2018
revised:
07
12
2018
accepted:
18
02
2019
pubmed:
25
2
2019
medline:
18
6
2020
entrez:
25
2
2019
Statut:
ppublish
Résumé
To date no definitive cut-off value for cytomegalovirus (CMV) DNA load in bronchoalveolar lavage (BAL) fluid specimens has been established to discriminate between CMV pneumonia and pulmonary CMV DNA shedding in allogeneic hematopoietic stem cell transplant (allo-HSCT) recipients. The current retrospective study is aimed at assessing the range of CMV DNA loads quantified in BAL fluid specimens from allo-HSCT patients with pneumonia in which different microorganisms were causally involved. A total of 144 BAL specimens from 123 patients were included. CMV DNA was detected in 56 out of 144 BAL fluid specimens and the median CMV DNA load from patients in whom CMV pneumonia was unlikely or could be tentatively ruled out was 1210 (31-68, 920) IU/ml. The frequency of CMV DNA detection and median CMV DNA loads were comparable, irrespective of the attributable cause of pneumonia. Detection of CMV DNA loads in BAL fluid specimens >500 IU/ml was independently associated with pneumonia-attributable mortality. The current study highlights the difficulty in establishing universal CMV DNA load thresholds in BAL fluid specimens for distinguishing between CMV pneumonia and pulmonary CMV DNA shedding, and suggests that the presence of CMV DNA in BAL fluid specimens beyond a certain level may have a deleterious impact on patient outcome.
Identifiants
pubmed: 30797790
pii: S0163-4453(19)30058-1
doi: 10.1016/j.jinf.2019.02.009
pmc: PMC7126576
pii:
doi:
Substances chimiques
DNA, Viral
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
393-401Informations de copyright
Copyright © 2019. Published by Elsevier Ltd.
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